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Mentoring Nurses in Familial Cancer Risk Assessment and Counseling: Lessons Learned From a Formative Evaluation

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Journal of Genetic Counseling

Abstract

Background. As familial cancer genetic services moves into community practice increased numbers of trained health professionals are needed to counsel individuals seeking cancer risk information. Nurses have been targeted to provide cancer risk assessment and counseling. To help prepare nurses for this role, a 5-day training in familial cancer risk assessment and counseling followed by a long-distance mentorship to support continued skill development in the work environment was conducted by Fox Chase Cancer Center, Philadelphia, PA. Methods. Four cohorts (N = 41) have completed the training and were randomized to either an immediate or delayed mentorship. A formative evaluation assessed the nurse’s ability to consult with other genetic health professionals and build self-efficacy in counseling skills via responses to questionnaire. A post-mentorship interview evaluated the usefulness, timing and length of the mentorship. Results. For both groups, there was a statistically significant improvement in self-efficacy for all skills from baseline to 6 months and an increased number of nurses consulting with genetic health professionals. All the nurses reported the value of the mentorship and those with less cancer risk counseling experience prior to the training needed support and resources for further skill and program development. Lessons learned from this formative evaluation are provided.

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References

  • Acheson, L. S., & Wiesner, G. L. (2004). Current and future applications of genetics in primary care medicine. Primary Care: Clinics in Office Practice, 31, 449–460.

    Article  PubMed  Google Scholar 

  • Acheson, L. S., Wiesner, G. L., Zyzanski, S. J., Goodwin, M. A., & Strange, K. C. (2000). Family history-taking in community family practice: Implications for genetic screening. Genetics in Medicine, 2, 180–185.

    Article  PubMed  CAS  Google Scholar 

  • American Association of Colleges of Nursing (1998). Essentials of baccalaureate education for professional education. Washington, DC.

  • American Nurses Association (2006). Essential nursing competencies and curriculum guidelines for genetics and genomics. Silver Springs, MD.

  • American Society of Clinical Oncology (1997). Resource documentation for curriculum development in cancer genetics. Journal of Clinical Oncology, 15, 2157–2169.

    Google Scholar 

  • American Society of Clinical Oncology (2004). ASCO curriculum: Cancer genetics & predisposition testing. Alexandria, VA: ASCO Publishing.

    Google Scholar 

  • American Society of Clinical Oncology (2006). Role of prevention in oncology practice; results from 2004 survey of American Society of Clinical Oncology members. In P. A.Ganz, L.Kwan, M. R.Somerfield, D.Alberts, J. E.Garber, K.Offit, et al. (Eds.) Journal of Clinical Oncology, 24(18), 2948–2957.

    Article  PubMed  Google Scholar 

  • Bandura, A. (1977). Social learning theory. Englewood Cliffs, NJ: Prentice-Hall.

    Google Scholar 

  • Barrows, H. S. (1993). An overview of the uses of standardized patients for teaching and evaluating clinical skills. Academic Medicine, 68, 443–451.

    Article  PubMed  CAS  Google Scholar 

  • Benner, P. (1984). From novice to expert: Excellence and power in clinical nursing practice. Addison-Wesley: Menlo Park.

    Google Scholar 

  • Bennett, C., Burton, H., & Farndon, P. (2007). Competences, education and support for new roles in cancer genetics: Outcomes from cancer genetics pilot projects. Familial Cancer, 6, 171–180.

    Article  PubMed  Google Scholar 

  • Bernhardt, B. A., Gellar, G., Doksum, T., et al. (2000). Evaluation of nurses and genetic counselors as providers of education about breast cancer susceptibility testing. Oncology Nursing Forum, 27, 33–39.

    PubMed  CAS  Google Scholar 

  • Blazer, K. R., Grant, M., Sand, S. R., MacDonald, D. J., Uman, G. C., & Weitzel, J. N. (2004). Effects of a cancer genetics education programme on clinician knowledge and practice. Journal of Medical Genetics, 41(7), 518–522.

    Article  PubMed  CAS  Google Scholar 

  • Blazer, K. R., Mac Donald, D. J., Ricker, C., Sand, S., Uman, G. C., & Weitzel, J. N. (2005). Outcomes from intensive training in genetic cancer risk counseling for clinicians. Genetics in Medicine, 1, 40–47.

    Article  Google Scholar 

  • Block, L. M., Claffey, C., Korow, M. K., & Mc Caffrey, R. (2005). Value of mentorship within nursing organizations. Nursing Forum, 40, 134–140.

    Article  PubMed  Google Scholar 

  • Byrne, M. W., & Keefe, M. R. (2002). Building research competence in nursing through mentoring. Journal of Nursing Scholarship, 34, 391–396.

    Article  PubMed  Google Scholar 

  • Burke, W. (2004). Genetic testing in primary care. Annual Review of Genomics and Human Genetics, 5, 1–14.

    Article  PubMed  CAS  Google Scholar 

  • Cornfeld, M., Miller, S., Ross, E., & Schneider, D. (2001). Accuracy of cancer-risk assessment in primary care practice. Journal of Cancer Education, 16, 193–198.

    PubMed  CAS  Google Scholar 

  • Del Mar, C., Galzxiou, P., & Mayer, D. (2004). Teaching evidence-based medicine should be integrated into current clinical scenarios. BMJ, 329, 989–990.

    Article  PubMed  Google Scholar 

  • Department of Health of Human Services; Hereditary Susceptibility Working Group (1998). Hereditary susceptibility to breast and ovarian cancer: An outline of fundamental knowledge needed by all healthcare professionals. Washington, DC: DHHS PHSOWH Government Printing Office.

    Google Scholar 

  • Di Vito-Thomas, P. A. (1998). Barmentoring: Mentoring and critical nursing behaviors among novice nurses in clinical nursing practice. Medsurg Nursing, 7, 110–113.

    PubMed  Google Scholar 

  • Ebbert, D. W., & Connors, H. (2004). Standardized patient experiences: Evaluation of clinical performance and nurse practitioner student satisfaction. Nursing Education Perspectives, 25(1), 12–15.

    PubMed  Google Scholar 

  • Emery, J., Walton, R., Murphy, M., Austoker, J., Yudkin, P., Chapman, C., et al. (2000). Computer support for interpreting family histories of breast and ovarian cancer in primary care: Comparative study with simulated cases. BMJ, 321, 28–32.

    Article  PubMed  CAS  Google Scholar 

  • Epplein, M., Koon, K. P., Ramsey, S. D., & Potter, J. D. (2005). Genetic services for familial cancer patients; a follow-up survey of National Cancer Institute Cancer Centers. Journal of Clinical Oncology, 23, 4713–4718.

    Article  PubMed  Google Scholar 

  • Fawcett, D. L. (2002). Mentoring—What this is and how to make this work. AORN Journal, 75, 950–954.

    Article  PubMed  Google Scholar 

  • Gaff, C., Aitken, M., Flouris, A., & Metcalfe, A. (2007). A model for development of genetics education programs for health professionals. Genetics in Medicine, 9, 451–457.

    Article  PubMed  Google Scholar 

  • Gaff, C., Aittomaki, K., & Williamson, R. (2001). Oncology nurse training in cancer genetics. Journal of Medical Genetics, 38, 691–695.

    Article  PubMed  CAS  Google Scholar 

  • Garber, J. E., & Offit, K. (2005). Hereditary cancer predisposition syndromes. Journal of Clinical Oncology, 23, 276–292.

    Article  PubMed  Google Scholar 

  • Gilboy, N., & Kane, D. (2004). Unfolding case based scenarios: A method of teaching and testing the critical thinking skills of newly licensed nurses. Journal of Emergency Nursing, 30(1), 83–85.

    Article  PubMed  Google Scholar 

  • Grimshaw, J. M., Winkens, R. A., Shirran, L., Cunningham, C., Mayhew, A., Thomas, R., et al. (2005). Interventions to improve outpatient referrals from primary care to secondary care. Cochrane Database Systematic Reviews, 20, CD005471.

  • Hampel, H., Sweet, K., Westman, J. A., Offit, K., & Eng, C. (2004). Referral for cancer genetics consultation: A review and compilation of risk assessment criteria. Journal Of Medical Genetics, 42, 81–91.

    Article  Google Scholar 

  • Haas, J. S., Kaplan, C. P., Gregorich, S., Perez-Stable, E. J., & Des Jerlais, G. (2004). Do physicians tailor their recommendations for breast cancer risk reduction based on patient’s risk? Journal of General Internal Medicine, 19, 302–309.

    Article  PubMed  Google Scholar 

  • International Society of Nurses in Genetics (2006). Provision of quality genetic services and care: Building a multidisciplinary, collaborative approach among genetic nurses and genetic counselors. Retrieved July 9, 2007 from www.isong.org/about/ps_multidisciplinarygeneticcare.cfm.

  • Joint Test and Technology Transfer Committee Working Group (2000). (362–365). Genetic testing for colon cancer: Joint statement of American College of Medical Genetics and American Society of Human Genetics. Genetics in Medicine, 2.

    Google Scholar 

  • Kaplan, C. P., Haas, J. S., Perez-Stable, E. J., Des Jerlais, G., Gregorich, S. E., et al. (2005). Factors affecting breast cancer risk reduction practices among California physicians. Preventive Medicine, 41, 7–15.

    Article  PubMed  Google Scholar 

  • Kauff, N. D., Scheuer, L., Robson, M. E., Glogowski, E., Kelly, B., & Barakat, R. (2001). Insurance reimbursement for risk-reducing mastectomy and oophorectomy in women with BRCA1 or BRCA2 mutations. Genetics in Medicine, 3, 422–425.

    Article  PubMed  CAS  Google Scholar 

  • Lea, D. H., & Lawson, M. T. (2000). A practice-based genetics curriculum for nurse educators: An innovative approach to integrating human genetics into nursing curricula. Journal of Nursing Education, 39, 418–421.

    PubMed  CAS  Google Scholar 

  • Lewellen-Williams, C., Johnson, V. A., Deloney, L. A., Thomas, B. R., Goyol, A., & Henry-Tillman, R. (2006). POD: A new model for mentoring underrepresented minority faculty. Academic Medicine, 81, 275–279.

    Article  PubMed  Google Scholar 

  • Lipton, L. R., Johnson, V., Cummings, C., Fisher, S., Risby, P., Eftekhar Sadat, A. T., et al. (2004). Refining Amsterdam Criteria and Bethesda Guidelines: Testing algorithms for prediction of mismatch repair mutation status in familial cancer clinic. Journal of Clinical Oncology, 15, 4934–4943.

    Article  Google Scholar 

  • Lynch, H. T., Boland, C. R., Rodriguez-Bigas, M. A., Amos, C., Lynch, J. F., & Lynch, P. M. (2007). Who should be sent for genetic testing in hereditary colorectal cancer syndromes? Journal of Clinical Oncology, 25(23), 3534–3542.

    Article  PubMed  Google Scholar 

  • MacIntosh, J., MacKay, E., Mallet Boucher, M., & Wiggins, N. (2002). Discovering co-learning with students in distance education sites. Nurse Educator, 27, 182.

    Article  PubMed  Google Scholar 

  • Masny, A., Daly, M., Ross, E., Balshem, A., Gillespie, D., & Weil, S. (2003). A training course for oncology nurses in familial cancer risk assessment; evaluation of knowledge and practice. Journal of Cancer Education, 18, 20–25.

    Article  PubMed  Google Scholar 

  • McCallister, M., O’Malley, K., Hopwood, P., Kerr, B., Howell, A., & Evans, D. G. (2002). Management of women with a family history of breast cancer in North West Region of England: Training for implementing a vision of future. Journal of Medical Genetics, 39, 531–535.

    Article  Google Scholar 

  • McKelvey, K. D., & Evans, J. P. (2003). Cancer genetics in primary care. Journal of Nutrition, 133(11 Suppl 1), 3767S–3772S.

    PubMed  CAS  Google Scholar 

  • Members on Expert Panel on Genetics and Nursing (2000). Report of expert panel on genetics and nursing: Implications for education and practice. Washington DC: US Department of Health and Human Services.

    Google Scholar 

  • Murff, H. J., Spigel, D. R., & Syngal, S. (2004). Does this patient have a family history of cancer? An evidence-based analysis of the accuracy of family cancer history. JAMA, 292, 1480–1489.

    Article  PubMed  CAS  Google Scholar 

  • Myers, M. F., Chang, M. H., Jorgensen, C., Whitworth, W., Kassim, S., Litch, J. A., et al. (2006). Genetic testing for susceptibility to breast and ovarian cancer; evaluating impact of a direct to consumer marketing campaign on physicians’ knowledge and practices. Genetics in Medicine, 8, 361–1370.

    Article  PubMed  Google Scholar 

  • National Cancer Institute (2007) Cancer genetics services directory. Retrieved June 20, 2007 from www.cancer.gov/search/geneticsservices/.

  • National Comprehensive Cancer Network (2007). Guidelines for detection, prevention & risk-reduction of cancer. Retrieved July 9, 2007 from www.nccn.org/professionals/physician_gls/default.asp.

  • National Society of Genetic Counselors (2007). Familial cancer risk counseling special interest group: 2007 first quarter report. Retrieved June 20, 2007 from www.nsgc.org.

  • Oncology Nursing Society (2007a). Cancer genetics special interest group. Retrieved June 20, 2007 from www.ons.org.

  • Oncology Nursing Society (2007b). Cancer genetics short course. Retrieved June 20, 2007 from http://www.ons.org/ceCentral/prevention/.

  • Owens, B. H., Herrick, C. A., & Kelley, J. A. (1998). A prearranged mentorship program: Can this work long distance? Journal of Professional Nursing, 14, 78–84.

    Article  PubMed  CAS  Google Scholar 

  • Prestholdt, C. O. (1990). Modern Mentoring: Strategies for developing contemporary nursing leadership. Nursing Administration Quarterly, 15, 20–27.

    PubMed  CAS  Google Scholar 

  • Prows, C. A., Hetteberg, C., Johnson, N., Latta, K., Lovell, A., Saal, H. M., et al. (2003). Outcomes of a genetics education program for nursing faculty. Nursing Education Perspectives, 24, 81–85.

    PubMed  Google Scholar 

  • Roesser, K., & Mullineaux, L. (2005). Genetic testing and hereditary cancer: Implications for nurses. Pittsburgh, PA: Oncology Education Services.

    Google Scholar 

  • Rosser, M., Rice, A. M., Campbell, H., & Jack, C. (2004). Evaluation of a mentorship programme for specialist practitioners. Nurse Education Today, 24, 596–604.

    PubMed  Google Scholar 

  • Secretary’s Advisory Committee on Genetics Health and Society (2004). Resolution of secretary’s advisory committee on genetics, health and society on genetics education and training of health professionals. Retrieved July 1, 2007 from http://www4.od.nih.gov/oba/sacghs.htm.

  • Thomka, L. A. (2007). Mentoring and impact on intellectual capital: Through eyes of a mentee. Nursing Administration Quarterly, 31, 22–26.

    PubMed  Google Scholar 

  • Tranin, A. S., Masny, A., & Jenkins, J. (Eds.) (2003). In Genetics in oncology practice: Cancer risk assessment. Pittsburgh, PA: Oncology Nursing Society.

  • Tyler, C. V., Jr., & Snyder, C. W. (2006). Cancer risk assessment: Examining the family physician’s role. Journal of the American Board of Family Medicine, 19, 468–477.

    Article  PubMed  Google Scholar 

  • United States Preventive Services Task Force (2005). Genetic risk assessment and BRCA mutation testing for breast and ovarian cancer susceptibility: Recommendation statement. Annals of Internal Medicine, 143, 355–361.

    Google Scholar 

  • Van Eps, M. A., Cooke, M., Creddy, D. K., & Walker, R. (2006). Mentor evaluation of a year-long mentorship program: A quality improvement initiative. Collegian, 13, 26–30.

    PubMed  Google Scholar 

  • Yerger Huffstutler, S., & Varnell, G. (2006). Impostor phenomenon in new nurse practitioner graduates. Medscape. Retrieved July 9, 2007, from http://www.medscape.com/viewarticle/533648.

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Acknowledgments

This training and mentoring program was supported with funds from R25 CA066061: (2002–2007), National Cancer Institute. Ropka: National Cancer Institute, National Institutes of Health, K07 CA088989.

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Correspondence to Agnes Masny.

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Masny, A., Ropka, M.E., Peterson, C. et al. Mentoring Nurses in Familial Cancer Risk Assessment and Counseling: Lessons Learned From a Formative Evaluation. J Genet Counsel 17, 196–207 (2008). https://doi.org/10.1007/s10897-007-9140-1

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  • DOI: https://doi.org/10.1007/s10897-007-9140-1

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